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A clinical prediction guide predicted progression to rheumatoid arthritis in undifferentiated arthritis

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 Q In patients with undifferentiated arthritis, can a prediction rule identify those who will progress to rheumatoid arthritis (RA)?

Clinical impact ratings Rheumatology ★★★★★★★


Embedded ImageDesign:

prospective cohort study with independent derivation and validation sets.

Embedded ImageSetting:

an arthritis clinic at a university in the Netherlands.

Embedded ImagePatients:

570 patients (mean age 51 y, 58% women) with recent onset arthritis formed the derivation cohort. 36 patients with recent onset arthritis in the placebo group of the Probaat (PROMPT) trial formed the validation cohort.

Embedded ImageDescription of prediction guide:

the guide had 9 questions: (1) age (× 0.02); (2) sex (1 point for female); (3) distribution of involved joints: small joint hands/feet (0.5 point), symmetric (0.5 point), upper extremities (1 point), upper and lower extremities (1.5 points); (4) score for morning stiffness on a 100-mm visual analogue scale: 26–90 mm (1 point), >90 mm (2 points); (5) number of tender joints: 4–10 …

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  • For correspondence: Dr A H van der Helm-van Mil, Leiden University Medical Center, Leiden, The Netherlands. AvdHelm{at}

  • Source of funding: not stated.